Perched on my general practitioner's examining table Monday, I waited to renew a prescription.
A quick knock and he appeared, wearing a pleated surgical mask. He said, "Might be getting the flu. My son had it this weekend. Started him on Tamiflu immediately. I know there's no scientific proof it works — and I paid $100 for it!"
That morning, I'd read Michael Specter's Annuls of Science article, "The Power of Nothing," so I said, "The placebo effect works."
By then, my doctor's masked face was buried in his iPad. "Should I send this prescription to the same pharmacy?" he asked.
My morning's read, subtitled, "Could studying the placebo effect change the way we think about medicine?" focused on a fascinating guy, Ted Kaptchuk, director of Harvard's Program in Placebo Studies — the first Harvard Medical School professor with neither a medical degree nor a doctorate. In fact, he studied acupuncture in Macau.
Now he says, "Clinical studies continually fail to demonstrate acupuncture's effectiveness," yet he's sure he healed people.
"I was a damn good healer," he says.
It's well accepted that a caring professional's touch is therapeutic, but Kaptchuk's Harvard program looks at the possible value of the "sugar pill" as a viable treatment. The Harvard institute, which has "recruited leading researchers from around the world," explores the "preposterous idea" that giving placebos deliberately as medicine might have a place in cures.
Naturally, the idea has critics, including Dr. Robert Temple, the Food and Drug Administration's deputy director, who says there are no data suggesting that placebos could function as drugs.
Yet, instances cited in Specter's article seem to suggest a placebo benefit. For example, in the 1980s, a National Center for Biotechnology study reported that "patients who were told they were going to receive a painkiller [but didn't] had the same experience as those secretly receiving between six and eight milligrams of morphine — a significant dose."
Kaptchuk himself ran a study where 80 irritable-bowel sufferers were divided into two groups. One half did not receive treatment. The others were told they were receiving placebos. The placebo group was also told that "rigorous clinical testing" has shown that placebos produce "significant mind-body self-healing." Patients who received the "openly distributed placebos … scored far better on standard assessments of their condition" and exhibited "statistically significant differences in severity of symptoms."
Today, we can observe the brain working to create, as Kaptchuk says "the biological mechanism driving these reactions." The August 2005 Scientific American article "Brain's Own Pain Relievers at Work in Placebo Effect, Study Suggests" explains how.
Researchers led by Jon-Kar Zubieta used PET brain scans to measure the activity of specific brain receptors. They gave a mildly painful experience to their research subjects. Some received an analgesic, and "others were told they were being given [pain] medicine but received none," Zubieta says. "We were able to see that the endorphin system was activated in pain-related areas of the brain, and that activity increased when someone was told that they were receiving medicine to ease their pain."
He added, "This deals a serious blow to the idea that the placebo effect is purely psychological."
I just had an experience where touch and professionalism worked.
Massage, adjustments and spas just don't appeal to me, but out of friendship, I agreed to be a "practice patient," for my friend's new foot reflexology student. Evelyne Huegi, the teacher, demonstrated reflex points that my feet loved. Her student followed. I don't know much about reflexology, but I am 100% certain that I left her Corona del Mar spa floating along in my sneakers.
My doctor cared for his son by paying for and administering the non-proven pill. Huegi's healing hands transformed my overused feet.
Makes me glad Harvard is devoting scientific rigor to the placebo. Harvard's Kaptchuk investigates ways to "broaden the definition of healing," beyond pills, surgeries and medical treatments.
We shouldn't lose sight of our goal, he says, "which is to make people feel better."